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Jul 1, 2015 · Traumatic Ocular Injuries. Definition: An injury to the eye occurring as a result of direct trauma. It may cause visual changes, eye pain/discomfort, and changes to the appearance of the eye. Approach: Be methodical with your history and physical. If the patient describes trauma that occurred to the eye, ask about the mechanism of the injury.
- Jeffrey Dela Cruz, MD
Serious traumatic eye injuries are relatively uncommon but...
- Ophthalmology
Corneal abrasions account for approximately 10% of...
- Trauma
Prehospital trauma team activation criteria allow for prompt...
- Jeffrey Dela Cruz, MD
- Disease Entity
- Diagnosis
- Management
Disease
Ocular penetrating and perforating injuries (commonly referred to as open globe injuries) can result in severe vision loss or loss of the eye. Penetrating injuries by definition are caused by a sharp object that penetrates into the eye (i.e. laceration) but not through and through--there is no exit wound. Perforating injuries go 'through and through' the eye and therefore have both an entrance and an exit wound. Typically, to constitute one of these injuries, a full-thickness wound through th...
Etiology
Penetrating or perforating ocular injuries can be due to injury from any sharp or high velocity object. Most individuals sustaining eye injuries are male with an estimated relative risk of 5.5 times greater than women. Average age of the patient is typically in their 30s. The home and workplace are the most frequent locations for injuries, and the most common situations were domestic assaults, battery assaults, and workplace accidents. The most common blunt objects reported by May et al from...
Risk Factors
As noted from the epidemiological studies above, male gender is a large risk factor for ocular trauma. Failure to wear adequate eye protection while performing high risk activities such as baseball, basketball and use of power tools in the home environment have also been noted to be risk factors for eye injuries.Substance abuse, including alcohol and marijuana, is also known to increase the risk of eye trauma.
History
It is important to obtain a thorough history from the patient to help identify the timing of the injury and mechanism. Any injuries other than the eye should be ascertained. Questions such as what the patient was doing during the injury and what potential objects could have caused the injury are important prior to physical evaluation. It is important to note whether safety glasses or prescription eyeglasses were being worn at the time of the injury. Also, make sure to ask the patient if he/ s...
Symptoms
Patients with penetrating or perforating injuries usually complain of pain, vision loss, or double vision. In more subtle injuries, there may be minor symptoms such as foreign body sensation or blurred vision. Severe redness, light sensitivity, and foreign body sensation are also symptoms of open globe injuries.
Signs
Subconjunctival hemorrhage, shallow or flat anterior chamber, hyper-deep anterior chamber, peaked pupil, corneal or scleral discontinuity, hyphema, iris deformities, uveal prolapse, lens disruption, or posterior segment findings such as vitreous hemorrhage, retinal tears, or retinal hemorrhage are concerning when seen in a patient with suspected trauma.
General treatment
Penetrating or perforating injuries should be evaluated and treated immediately. Depending on the material causing the injury and location of entry, severe vision loss can occur. The Ocular Trauma Score (OTS) was developed in 2002 from a cohort of 2500 eye injuries and visual recovery as a way to assess prognosis of visual recovery post injury. A raw score from 0-100 is calculated based on initial post-injury VA, rupture of the globe, endophthalmitis, penetration of the globe, presence of ret...
Surgery
In cases with a high suspicion for penetrating or perforating eye trauma, globe exploration should be performed with possible vitrectomy if vitreous hemorrhage with an intraocular foreign body or retinal detachment is present. In cases of confirmed penetrating or perforating eye trauma, prompt closure of the open globe is recommended primarily focusing on anterior segment structures, with all attempts made to restore the entire wall of the eye to its pre-trauma state. Lacerations of the corne...
Prognosis
There are a number of risk factors on initial presentation that can be used to predict ultimate visual prognosis following an ocular penetrating or perforating injury. By far the most predictive prognostic factor is the initial visual acuity on presentation, as well as injury to zone III, history of corneal transplantation, presence of RAPD, time from injury, and presence of retinal detachment and/or vitreous hemorrhage, and crystalline lens dislocation. The OTS is also a useful tool to get a...
you have a headache, high temperature or sensitivity to light. you're feeling sick or being sick after an eye injury. you cannot move your eye or keep it open. blood or pus is coming from your eye. Find your nearest A&E. Do not drive to A&E. Ask someone to drive you or call 999 and ask for an ambulance. Bring any medicines you take with you.
Dec 28, 2023 · Eye trauma is an important cause of monocular visual impairment and blindness that most commonly affects working age males. Worldwide, an estimated 55 million people experience an eye injury each year, with 1.6 million developing blindness, 2.3 million developing bilateral low vision, and almost 19 million developing unilateral blindness or low vision.
Feb 27, 2019 · Some common eye injuries, such as deep puncture wounds from accidents, could require immediate treatment or surgery to prevent permanent eye damage resulting in vision loss. Minor surface scratches, on the other hand, may need only simple monitoring after an initial visit to the eye doctor to make sure complications such as eye infections don't occur.
- Common causes of abrasions to the eye's surface (corneal abrasions) are getting poked in the eye or rubbing the eye when a foreign body is present,...
- If a foreign object such as metal or a fish hook penetrates your eye, visit the emergency room/urgent care center right away. You could cause even...
- Getting unexpectedly splashed or sprayed in the eye by substances other than clean, harmless water can be scary. Some substances burn or sting but...
- This eye injury usually looks worse than it really is. A subconjunctival hemorrhage involves leakage of blood from one or more breaks in a blood ve...
- A hyphema (high-FEE-mah) is bleeding in the anterior chamber of the eye, the space between the cornea and the iris. Orbital blowout fractures are c...
- If you have any eye injury, contact your eye care practitioner immediately for advice.Most eye doctors have emergency contact numbers for injuries...
Superficial corneal injuries are non-penetrating injuries affecting the outermost layer of the cornea. Corneal abrasions are defects in the epithelial surface of the cornea — most heal within 1–2 days. Superficial corneal injuries typically present with sudden onset pain, discomfort or foreign body sensation of the eye and tearing.
People also ask
Can a puncture wound cause vision loss?
What are ocular penetrating and perforating injuries?
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What causes eye injuries?
May 14, 2024 · Common types of eye injuries include: Black eye: A blow to your eye and the tissues around it causes bruising, otherwise known as a black eye. A bruised eye usually refers to the tissues around your eye, rather than the eye itself. The area around your eye will be swollen and discolored like a bruise, in shades of black, blue or purple.
